Therapeutic Role of Nitric Oxide in Respiratory Disease

Thomas E. Siddons, BSc, Mohammed Asif, MA, BMBCh, FRCS, and Tim W. Higenbottam, MD, MA, BSc, FRCP, University of Sheffield, Sheffield, United Kingdom

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Efficacy of Inhaled NO

Controlled, prospective, multicenter trials that focus on whether inhaled NO significantly increases the chances of survival in patients with severe ARDS are lacking. Several studies have reviewed retrospective data and attempted to evaluate the effect of inhaled NO on hemodynamics and gas exchange. Rossaint and colleagues[9] studied 87 patients with severe disease. They found that use of inhaled NO increased the ratio of PaO2 to the fraction of inspired oxygen in 83% of patients by more than 10%;[9] in addition, 63% of the patients demonstrated a decrease in mean pulmonary artery pressure by more than 3 mm Hg. Young and colleagues[10] have suggested that the degree of improvement seen in PaO2 is directly proportional to the degree of pulmonary hypertension before treatment.[10]

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